Fetal cerebrovascular response to chronic hypoxia - implications for the prevention of brain damage

Znanstveni rad - Izvorni znanstveni rad

• Autor: Aida Salihagić-Kadić
• Autor: Marijana Medić
• Autor: Domagoj Jugović
• Autor: Milan Kos
• Autor: Višnja Latin
• Autor: Marija Kušan-Jukić
• Autor: Philippe Arbeille
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Kliničke medicinske znanosti

Sažetak (engleski)

Fetal hypoxia is one of the leading causes of perinatal morbidity and mortality. One of the most severe sequels of fetal hypoxic insult is the development of perinatal brain lesions resulting in a spectrum of neurological disabilities, from minor cerebral disorders to cerebral palsy. One of the most important fetal adaptive responses to hypoxia is redistribution of blood flow towards the fetal brain, known as the 'brain sparing effect'. The fetal blood flow redistribution in favor of the fetal brain can be detected and quantified by the Doppler cerebral/umbilical ratio (C/U ratio = cerebral resistance index (CRI)/umbilical resistance index (URI)). Our studies on animal models and human fetuses have demonstrated clearly that this phenomenon cannot prevent the development of perinatal brain lesions in the case of severe or prolonged hypoxia. Fetal deterioration in chronic and severe hypoxia is characterized by the disappearance of the physiological cerebral vascular variability (vasoconstriction and vasodilatation), followed by an increase in cerebral vascular resistance. However, our latest study on growth-restricted and hypoxic human fetuses has shown that perinatal brain lesions can develop even before the loss of cerebrovascular variability. The fetal exposure to hypoxia can be quantified by using a new vascular score, the hypoxia index. This parameter, which takes into account the degree as well as duration of fetal hypoxia, can be calculated by summing the daily % C/U ratio reduction from the cut-off value 1 over the period of observation. According to our results, the use of this parameter, which calculates the cumulative, relative oxygen deficit, could allow for the first time the sensitive and reliable prediction and even prevention of adverse neurological outcome in pregnancies complicated by fetal hypoxia.

• Ključne riječi (engleski): Brain/pathology; Cerebrovascular Circulation/physiology; Female; Fetal Growth Retardation/etiology; Fetal Hypoxia/etiology; Fetal Hypoxia/physiopathology; Gestational Age; Humans; Hypoxia, Brain/etiology; Hypoxia, Brain/prevention & control; Placental Insufficiency/physiopathology; Placental Insufficiency/ultrasonography; Pregnancy; Ultrasonography, Prenatal
• Jezik: engleski
• Vrsta publikacije: Znanstveni rad - Izvorni znanstveni rad
• Status objave: Objavljen
• Vrsta recenzije: Recenziran
• Verzija publikacije: Završna verzija rukopisa prihvaćena za objavljivanje (postprint)
• Naslov časopisa: The Journal of Maternal-fetal & Neonatal medicine
• Brojčani podaci: vol. 19, br. 7, str. 387-396
• p-ISSN: 1476-7058
• DOI: https://doi.org/10.1080/14767050600637861
• URN:NBN: urn:nbn:hr:105:662167
• Datum objave publikacije: 2006-07
• URL dokumenta: https://doi.org/10.1080/14767050600637861
• Vrsta resursa: Tekst
• Prava pristupa: Otvoreni pristup
• Datum i vrijeme pohrane: 2024-03-28 11:23:48